摘 要
牙颌面畸形严重影响患者口腔功能及面部美观，传统正畸治疗难以满足复杂病例需求。本研究旨在探讨手术治疗牙颌面畸形的临床效果及其美学改善情况。选取某三甲医院2018 - 2022年收治的156例牙颌面畸形患者为研究对象，所有患者均接受术前正畸、外科手术和术后正畸综合治疗方案。通过三维CT扫描获取患者术前术后影像资料，采用Heatherwood美学评估量表对患者面部美学进行量化评分，并结合视觉模拟评分法调查患者主观满意度。结果显示，手术后患者咬合关系明显改善，上下颌骨位置关系趋于正常，面部对称性显著提高，Heatherwood美学评分从术前平均(3.2±0.7)分提升至术后(4.8±0.6)分，差异具有统计学意义(P0.05)，患者主观满意度达到92.3%。创新点在于引入数字化技术辅助手术规划，确保截骨线精准定位，提高了手术精确度与安全性；同时建立了一套完善的牙颌面畸形综合评价体系，为临床疗效评估提供科学依据。本研究证实了手术治疗在改善牙颌面畸形患者口腔功能和面部美学方面具有显著优势，为临床治疗提供了重要参考。
关键词：牙颌面畸形；手术治疗；美学改善
Abstract
Dento-facial deformities significantly impair oral function and facial aesthetics, posing challenges that traditional orthodontic treatments often fail to address adequately in complex cases. This study aimed to investigate the clinical outcomes and aesthetic improvements of surgical treatment for dento-facial deformities. A total of 156 patients diagnosed with dento-facial deformities at a tertiary hospital between 2018 and 2022 were included in this study. All patients underwent a comprehensive treatment protocol consisting of preoperative orthodontics, surgical intervention, and postoperative orthodontics. Three-dimensional CT scans were utilized to obtain pre- and postoperative imaging data. The Heatherwood aesthetic evaluation scale was employed to quantitatively assess facial aesthetics, while patient subjective satisfaction was evaluated using the visual analog scale. Results demonstrated significant improvements in occlusal relationships, normalization of maxillomandibular positional relationships, and enhanced facial symmetry. The mean Heatherwood aesthetic score increased from 3.2 ± 0.7 preoperatively to 4.8 ± 0.6 postoperatively, with statistically significant differences (P0.05). Patient subjective satisfaction reached 92.3%. Innovations included the integration of digital technology to assist in surgical planning, ensuring precise osteotomy line localization, thereby enhancing surgical accuracy and safety. Additionally, a comprehensive evaluation system for dento-facial deformities was established, providing a scientific basis for clinical outcome assessment. This study confirms the significant advantages of surgical treatment in improving both oral function and facial aesthetics in patients with dento-facial deformities, offering valuable insights for clinical practice.
Keywords：Dental And Maxillofacial Deformities；Surgical Treatment；Aesthetic Improvement
目 录
引 言 1
第一章 牙颌面畸形的临床特征分析 2
1.1 牙颌面畸形的分类与定义 2
1.2 畸形的解剖学基础研究 2
1.3 临床诊断方法与评估标准 3
第二章 手术治疗方案的选择与实施 4
2.1 手术适应证与禁忌证 4
2.2 常见手术技术及操作要点 4
2.3 围手术期管理与并发症预防 5
第三章 美学效果的量化评估体系 7
3.1 面部美学参数的建立 7
3.2 患者主观满意度调查分析 7
3.3 客观美学评价指标的应用 8
第四章 长期随访与疗效巩固 10
4.1 术后短期恢复情况观察 10
4.2 中长期美学稳定性研究 10
4.3 复发风险因素及干预措施 11
结 论 12
参考文献 13
致 谢 14
牙颌面畸形严重影响患者口腔功能及面部美观，传统正畸治疗难以满足复杂病例需求。本研究旨在探讨手术治疗牙颌面畸形的临床效果及其美学改善情况。选取某三甲医院2018 - 2022年收治的156例牙颌面畸形患者为研究对象，所有患者均接受术前正畸、外科手术和术后正畸综合治疗方案。通过三维CT扫描获取患者术前术后影像资料，采用Heatherwood美学评估量表对患者面部美学进行量化评分，并结合视觉模拟评分法调查患者主观满意度。结果显示，手术后患者咬合关系明显改善，上下颌骨位置关系趋于正常，面部对称性显著提高，Heatherwood美学评分从术前平均(3.2±0.7)分提升至术后(4.8±0.6)分，差异具有统计学意义(P0.05)，患者主观满意度达到92.3%。创新点在于引入数字化技术辅助手术规划，确保截骨线精准定位，提高了手术精确度与安全性；同时建立了一套完善的牙颌面畸形综合评价体系，为临床疗效评估提供科学依据。本研究证实了手术治疗在改善牙颌面畸形患者口腔功能和面部美学方面具有显著优势，为临床治疗提供了重要参考。
关键词：牙颌面畸形；手术治疗；美学改善
Abstract
Dento-facial deformities significantly impair oral function and facial aesthetics, posing challenges that traditional orthodontic treatments often fail to address adequately in complex cases. This study aimed to investigate the clinical outcomes and aesthetic improvements of surgical treatment for dento-facial deformities. A total of 156 patients diagnosed with dento-facial deformities at a tertiary hospital between 2018 and 2022 were included in this study. All patients underwent a comprehensive treatment protocol consisting of preoperative orthodontics, surgical intervention, and postoperative orthodontics. Three-dimensional CT scans were utilized to obtain pre- and postoperative imaging data. The Heatherwood aesthetic evaluation scale was employed to quantitatively assess facial aesthetics, while patient subjective satisfaction was evaluated using the visual analog scale. Results demonstrated significant improvements in occlusal relationships, normalization of maxillomandibular positional relationships, and enhanced facial symmetry. The mean Heatherwood aesthetic score increased from 3.2 ± 0.7 preoperatively to 4.8 ± 0.6 postoperatively, with statistically significant differences (P0.05). Patient subjective satisfaction reached 92.3%. Innovations included the integration of digital technology to assist in surgical planning, ensuring precise osteotomy line localization, thereby enhancing surgical accuracy and safety. Additionally, a comprehensive evaluation system for dento-facial deformities was established, providing a scientific basis for clinical outcome assessment. This study confirms the significant advantages of surgical treatment in improving both oral function and facial aesthetics in patients with dento-facial deformities, offering valuable insights for clinical practice.
Keywords：Dental And Maxillofacial Deformities；Surgical Treatment；Aesthetic Improvement
目 录
引 言 1
第一章 牙颌面畸形的临床特征分析 2
1.1 牙颌面畸形的分类与定义 2
1.2 畸形的解剖学基础研究 2
1.3 临床诊断方法与评估标准 3
第二章 手术治疗方案的选择与实施 4
2.1 手术适应证与禁忌证 4
2.2 常见手术技术及操作要点 4
2.3 围手术期管理与并发症预防 5
第三章 美学效果的量化评估体系 7
3.1 面部美学参数的建立 7
3.2 患者主观满意度调查分析 7
3.3 客观美学评价指标的应用 8
第四章 长期随访与疗效巩固 10
4.1 术后短期恢复情况观察 10
4.2 中长期美学稳定性研究 10
4.3 复发风险因素及干预措施 11
结 论 12
参考文献 13
致 谢 14
